HESI RN
Leadership HESI Quizlet
1. Albert, a 35-year-old insulin-dependent diabetic, is admitted to the hospital with a diagnosis of pneumonia. He has been febrile since admission. His daily insulin requirement is 24 units of NPH. Every morning Albert is given NPH insulin at 0730. Meals are served at 0830, 1230, and 1830. The nurse expects that the NPH insulin will reach its maximum effect (peak) between the hours of:
- A. 1130 and 1330.
- B. 1330 and 1930.
- C. 1530 and 2130.
- D. 1730 and 2330.
Correct answer: C
Rationale: NPH insulin typically peaks 4-12 hours after administration, so a peak between 1530 and 2130 would be expected. Choice A (1130 and 1330) is too early for the peak effect of NPH insulin. Choice B (1330 and 1930) falls within the possible peak period but is not as accurate as choice C. Choice D (1730 and 2330) is too late for the peak effect of NPH insulin based on the typical peak timing.
2. A client with a diagnosis of renal failure is receiving hemodialysis. Which assessment finding should the nurse report to the healthcare provider immediately?
- A. The client's blood pressure is 130/80 mm Hg.
- B. The client gains 1 kg in 24 hours.
- C. The client's potassium level is 5.5 mEq/L.
- D. The client's weight decreases by 0.5 kg in 24 hours.
Correct answer: C
Rationale: A potassium level of 5.5 mEq/L (C) is elevated and concerning in a client with renal failure receiving hemodialysis, as it can lead to life-threatening cardiac arrhythmias. Monitoring blood pressure (A), weight gain (B), and weight loss (D) are essential in clients on hemodialysis, but an elevated potassium level poses an immediate risk that requires prompt intervention.
3. A 5-week-old infant with hypertrophic pyloric stenosis has developed projectile vomiting over the last two weeks. Which intervention should the nurse plan to implement?
- A. Instruct the mother to give sugar water only.
- B. Offer the infant oral rehydration every 2 hours.
- C. Provide Pedialyte feedings via nasogastric tube.
- D. Maintain intravenous fluid therapy.
Correct answer: D
Rationale: The correct intervention for a 5-week-old infant with hypertrophic pyloric stenosis presenting with projectile vomiting is to maintain intravenous fluid therapy. This is essential to maintain hydration before surgery. Instructing the mother to give sugar water only (Choice A) is inadequate and does not address the need for proper hydration. Offering oral rehydration every 2 hours (Choice B) may not be effective in cases of severe vomiting and could lead to further fluid loss. Providing Pedialyte feedings via nasogastric tube (Choice C) is an option, but in severe cases, intravenous fluid therapy is more effective in ensuring hydration and electrolyte balance.
4. A client who is receiving oxytocin to augment early labor begins to experience tachysystolic tetanic contractions with variable fetal heart decelerations. Which action should the nurse implement?
- A. Turn off the oxytocin infusion.
- B. Reposition the fetal monitor transducers.
- C. Decrease the rate of the oxytocin infusion.
- D. Alert the charge nurse about the patient's condition.
Correct answer: A
Rationale: When a client experiences tachysystolic tetanic contractions with variable fetal heart decelerations, indicating uterine hyperstimulation, the priority action is to turn off the oxytocin infusion. This step aims to reduce uterine activity, which can compromise fetal oxygenation and lead to adverse outcomes.
5. A client being discharged with a prescription for the bronchodilator theophylline is instructed to take three doses of the medication each day. Since timed-release capsules are not available, which dosing schedule should the nurse advise the client to follow?
- A. 9 a.m., 1 p.m., and 5 p.m.
- B. 8 a.m., 4 p.m., and midnight.
- C. Before breakfast, before lunch, and before dinner.
- D. With breakfast, with lunch, and with dinner.
Correct answer: B
Rationale: Theophylline should be administered on a regular around-the-clock schedule to provide the best bronchodilating effect and reduce the potential for adverse effects. The correct dosing schedule of 8 a.m., 4 p.m., and midnight ensures that the client receives consistent dosing throughout the day. Other options do not provide the necessary around-the-clock coverage. It's important to note that food may affect the absorption of the medication, which is why the dosing schedule should not be tied to meal times.